Information and public services

Weighing sunlight

Shame might be as important a tool as choice in improving public services

INFORMATION is power, or so the coalition government believes when it comes to improving the public services. It is planning to release a deluge of data on matters ranging from school exams to the time spent in hospital by patients recovering from surgery. The aim is to inform and encourage choice, which in theory will raise standards. The evidence suggests that approach is half right: releasing such information helps, but it seems often to be most effective when it is directed at professionals rather than punters, and when it focuses on individuals rather than institutions.

Andrew Lansley, the health secretary, recently launched a set of consultations on what he calls the “information revolution” in the National Health Service. He plans to make data on matters such as hospital waiting times, cleanliness, infection rates, emergency readmissions and patient satisfaction more easily available. One of Michael Gove's first acts on being appointed education secretary, meanwhile, was to place information on school performance prominently on his department's website. For their part, universities have been told that they must provide clearer guidance about their courses. The idea is that this transparency will help people to choose their hospital, school or university.

But how many actually will? Only a minority of university applicants seek out the data that universities already publish on graduate employment rates, according to research by Staffordshire University (though that may change as tuition fees rise). As for hospitals, a study by the King's Fund, a think-tank, suggests that patients who exercise their right to choose their hospital, often older and better-educated ones, base their decisions not on published figures but on past experience and the advice of their doctor. Only a minority of parents—typically the “sharp-elbowed middle-class” kind, as David Cameron calls them—have in the past made use of school-inspection reports and the unofficial league tables devised by newspapers.

Nevertheless, those league tables do seem to be effective. Research led by Simon Burgess, of the University of Bristol, found that pupils at English schools have been doing better than those in Wales, where since 2001 the devolved administration has not released the data on which league tables are based. However, the researchers attributed the gap to the shaming effect of poor rankings on teachers and governors, rather than parental choices.

Other evidence supports the idea that embarrassing practitioners in the eyes of their colleagues works. Since 1996, the Society for Cardiothoracic Surgery has published a database that allows doctors to compare their own clinical performance to national and international standards. Underperforming surgeons have begun to emulate the more successful: between 2001 and 2008, the proportion of patients who survived heart surgery increased significantly, even though the same surgeons were treating ever sicker people. Alf Collins, a doctor who advises the Department of Health, thinks all clinicians should have personalised (and published) scorecards to stop them blaming one another for failures. Teachers could be classified as “good” or “bad” according to the academic progress of their pupils, says Dylan Wiliam of the Institute of Education.

Naturally, not everyone welcomes such scrutiny. The Los Angeles Times recently ranked 6,000 teachers in California according to the progress (or otherwise) of their pupils. Hundreds of teachers protested outside its offices. One of the teachers whose self-esteem took a knock was Michael Lyon of the Russell Elementary School in Los Angeles. He says the blow made him determined to improve his teaching so his students get better grades. Appealing to public servants' professional pride may be the best way to motivate them—even if it sometimes gets bruised.